Translating IT into Better Healthcare

As the nation seeks to solve the conundrum of its troubled healthcare system, information technology- including electronic medical records and telemedicine- will be a critical element of the solution. But healthcare has been slow to adopt IT, for a variety of reasons. WPI's Bengisu Tulu is helping the industry clear the hurdles that stand in the way of its realizing the full benefits of modern information systems.

When you think about modern medicine, you think about technology: advanced imaging systems, diagnostic labs filled with analytical equipment, even robotic assistants in the operating room. Ironically, the healthcare industry has been one of the slowest to embrace information technology. The reasons are complex, says Bengisu Tulu, assistant professor of management at WPI, whose research focuses on finding ways to overcome the hurdles that keep medical professionals from making use of the full benefits of information systems.

Tulu says that some of the IT problems in healthcare stem from communications breakdowns. Developers of information systems fail to understand what users want the systems to do. Computer systems that manage medical records and billing follow different rules and can’t easily share information. Systems made by different manufacturers can’t talk to each other seamlessly. "Often," she says, "my role is to serve as the translator."

A good case in point, Tulu explains, is the way electronic medical systems deal with (or more often, don’t deal with) the particular issues that face people with disabilities. "Typical medical records systems are focused on treatment, but people with disabilities are also concerned about benefits. They need to be compensated for their medical care, and their medical records are the legal evidence required to support their claims."

Benefits administrators use a ratings system to evaluate claims, but those ratings don’t map well onto the treatment codes that doctors use, causing delays in payments. While working on her PhD in the School of Information Systems and Technology at Claremont Graduate University, Tulu was part of a research group that helped gain national visibility for this issue and proposed solutions that will help electronic medical record systems bridge this costly gap.

The work caught the attention of the Social Security Administration, one of the nation’s largest payers of medical benefits, which is now committed to working toward the seamless transfer of medical evidence from healthcare providers to the agency, notes Tulu. "This is exactly why we work in this field. This issue matters to a lot of people, and the impact of this work can be significant."

As an information technology translator, Tulu often works to open a productive dialog between teams in healthcare organizations charged with improving processes and those that implement new technology. "You really need to be sure these groups talk to each other,” she says. "Technology and processes need to be planned and designed together. When that does not happen, people become frustrated because there are many changes coming at them and they may well conf lict."

Over the past two years, Tulu has had the opportunity to put this theory into practice in a project that produced a rare medical IT triumph. Tulu worked with one of the largest not-for-profit health organizations in Oklahoma to set up a telestroke network. Telestroke is a way of using video technology to connect rural hospitals that don’t have stroke specialists on staff with larger medical centers that do. It allows patients in remote areas who may have suffered a stroke to be diagnosed and treated with the clot-busting drug tPA in the brief window of time when that medication can be safely administered.

The health organization in Oklahoma had been involved with telehealth for more than 15 years, Tulu says, before embarking on the telestroke project. "They said, 'We've made a lot of mistakes and learned from them. We want to do this one right.'"

Tulu and her team were offered the opportunity to become involved before the first site was set up and observe the implementation process as new sites were brought up. The health system paired someone from the process development group with the telehealth group so the process design and the technology were integrated seamlessly. "The people in the emergency rooms using the system are very happy," she says. "It shows that if you come in as one group and make all of the changes as one solution, the healthcare profession will find that it makes sense."

Currently, Tulu is applying the lessons learned in Oklahoma to a new telehealth project with the plastic surgery division of the University of Massachusetts Medical School. Patients with chronic wounds need to be seen by a group of specialists regularly, but the consultations tend to be brief. "The patients, who usually have other serious medical problems, sometimes have to be transported by ambulance from hours away, and those trips can have a deleterious effect on the wounds."

Working with Dr. Raymond Dunn '78, chief of the division of plastic surgery, and Peder Pederson, professor of electrical and computer engineering at WPI, Tulu hopes to help develop a system that will enable wound care specialists to view images of patients' wounds remotely and decide if an in-person visit is warranted. "This could result in considerable savings and better outcomes for patients," she says.

Tulu is pursuing this and other projects through WPI's new Center for eHealth Innovation and Process Transformation, an interdisciplinary research center working to improve healthcare delivery through engineering, management, and information technology. The task before the center is daunting, Tulu says, for as the nation seeks to reform its troubled healthcare system, technology—from electronic medical records to telemedicine—will play an increasingly important role. "We will continue to have problems with adoption," she says, "until we can get to a point where we can create good systems that are designed for the user and supported by a good mechanism. We need to be happy with the whole healthcare system, not just the technology."

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Last modified: July 09, 2010 11:18:09